Enterobius vermicularis Infestation: A Rare Cause of Appendicitis

<i>Enterobius vermicularis</i> (<i>E. vermicularis</i>, pinworm) is a common gastrointestinal parasite in children, occasionally implicated in appendiceal pathology. We report a case of a seven-year-old autistic male who presented with a three-day history of right iliac fossa pain, fever, nausea, and vomiting. Clinical and laboratory findings suggested acute appendicitis, prompting diagnostic laparoscopy and appendicectomy. Intraoperatively, a mildly inflamed appendix was noted with multiple mesenteric lymph nodes and visible roundworms at the appendiceal base, which were carefully suctioned out. Histopathology confirmed <i>E. vermicularis</i> infestation without definitive acute inflammatory changes. The patient had an uneventful recovery with postoperative anthelmintic therapy for the household. While the role of <i>E. vermicularis</i> in true appendicitis remains debated, its presence within the appendix can cause symptoms mimicking acute appendicitis. Given the diagnostic uncertainty and potential risk of appendiceal obstruction or secondary infection, appendicectomy remains a definitive and justified treatment in such cases, ensuring symptom resolution and preventing complications.